Abstract：
OBJECTIVE: We aimed to investigate the prognostic factors of pediatric extracorporeal cardiopulmonary resuscitation (ECPR).
METHODS: The retrospective study included a total of 77 pediatric cases (7 neonates and 70 children) who underwent ECPR after in-hospital and out-of-hospital cardiac arrest between July 2007 and December 2022. Primary endpoints were complications, while secondary endpoints included all-cause in-hospital mortality.
RESULTS: Among the 45 cases experiencing complications, 4 neonates and 41 children had multiple simultaneous complications, primarily neurological issues in 25 cases. Additionally, organ failure occurred in 11 cases, and immunodeficiency was present in two cases. Furthermore, 9 cases experienced bleeding events, and 13 cases showed thrombosis. Patients with complications had lower weight, shorter ECMO durations, and longer CPR durations. Non-survivors had longer CPR durations and shorter durations of ECMO, ICU stay, and mechanical ventilation compared to survivors. Complications were more prevalent in non-survivors, particularly organ failure and bleeding events.
CONCLUSIONS: Weight, CPR duration, and ECMO duration were associated with complications, suggesting areas for treatment optimization. The higher occurrence of complications in non-survivors underscores the importance of early detection and management to improve survival rates. Our findings suggest clinicians consider these factors in prognostic assessments to enhance the effectiveness of ECPR programs.
METHODS: The retrospective study included a total of 77 pediatric cases (7 neonates and 70 children) who underwent ECPR after in-hospital and out-of-hospital cardiac arrest between July 2007 and December 2022. Primary endpoints were complications, while secondary endpoints included all-cause in-hospital mortality.
RESULTS: Among the 45 cases experiencing complications, 4 neonates and 41 children had multiple simultaneous complications, primarily neurological issues in 25 cases. Additionally, organ failure occurred in 11 cases, and immunodeficiency was present in two cases. Furthermore, 9 cases experienced bleeding events, and 13 cases showed thrombosis. Patients with complications had lower weight, shorter ECMO durations, and longer CPR durations. Non-survivors had longer CPR durations and shorter durations of ECMO, ICU stay, and mechanical ventilation compared to survivors. Complications were more prevalent in non-survivors, particularly organ failure and bleeding events.
CONCLUSIONS: Weight, CPR duration, and ECMO duration were associated with complications, suggesting areas for treatment optimization. The higher occurrence of complications in non-survivors underscores the importance of early detection and management to improve survival rates. Our findings suggest clinicians consider these factors in prognostic assessments to enhance the effectiveness of ECPR programs.
摘要：
目的：我们旨在探讨影响小儿体外心肺复苏（ECPR）预后的因素。
方法：回顾性研究纳入了2007年7月至2022年12月期间住院和院外心脏骤停后接受ECPR的77例儿科病例（7例新生儿和70例儿童）。主要终点是并发症，次要终点包括全因住院死亡率.
结果：在45例并发症中，4名新生儿和41名儿童同时出现多种并发症，25例主要是神经系统问题。此外,11例发生器官衰竭，在两个病例中存在免疫缺陷。此外，9例发生出血事件，13例显示血栓形成。有并发症的患者体重较低，更短的ECMO持续时间，和更长的CPR持续时间。非幸存者的CPR持续时间较长，ECMO持续时间较短，ICU停留,与幸存者相比，机械通气。并发症在非幸存者中更为普遍，尤其是器官衰竭和出血事件。
结论：体重，CPR持续时间,ECMO持续时间与并发症相关，建议优化治疗区域。非幸存者并发症发生率较高，强调了早期发现和管理以提高生存率的重要性。我们的研究结果表明，临床医生在预后评估中考虑这些因素，以提高ECPR计划的有效性。
方法：回顾性研究纳入了2007年7月至2022年12月期间住院和院外心脏骤停后接受ECPR的77例儿科病例（7例新生儿和70例儿童）。主要终点是并发症，次要终点包括全因住院死亡率.
结果：在45例并发症中，4名新生儿和41名儿童同时出现多种并发症，25例主要是神经系统问题。此外,11例发生器官衰竭，在两个病例中存在免疫缺陷。此外，9例发生出血事件，13例显示血栓形成。有并发症的患者体重较低，更短的ECMO持续时间，和更长的CPR持续时间。非幸存者的CPR持续时间较长，ECMO持续时间较短，ICU停留,与幸存者相比，机械通气。并发症在非幸存者中更为普遍，尤其是器官衰竭和出血事件。
结论：体重，CPR持续时间,ECMO持续时间与并发症相关，建议优化治疗区域。非幸存者并发症发生率较高，强调了早期发现和管理以提高生存率的重要性。我们的研究结果表明，临床医生在预后评估中考虑这些因素，以提高ECPR计划的有效性。
